Provider Demographics
NPI:1275774895
Name:BELALCAZAR, MILDER (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MILDER
Middle Name:
Last Name:BELALCAZAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E POST RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-5113
Mailing Address - Country:US
Mailing Address - Phone:914-995-5262
Mailing Address - Fax:914-995-5254
Practice Address - Street 1:25 OPERATIONS DR
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1586
Practice Address - Country:US
Practice Address - Phone:914-231-4210
Practice Address - Fax:914-231-4274
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071034-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY071034-1OtherNYS LICENSE